Rectal examination in paediatric surgical practice

'If you don't put your finger in it, you risk putting pour foot in it.''1 ' You should never omit the rectal examination from pour routine examination. '2 'The abdominal examination is not complete without the performance of a rectal examination.'3 Such phrases are deeply ingrained in medical teaching and give the impression that a rectal examination is an obligatory part of surgical clinical assessment. Documentation of a rectal examination has be en used as an indicator of a thorough physical examination4. A normal recta l examination has been described among the required discharge criteria for children following appendicectomy5. The following article argues that in ch ildren rectal examination is a specialist investigation and should only be performed in certain limited situations. The evidence offered for this incl udes a comparison of the characteristics of rectal examination with those o f an ideal investigation, a review of the possible indications and consider ation of who should perform a rectal examination when required.